By Melina Alborzi

Graphic design by Allison Conwell

Somewhere between wellness podcasters Joe Rogan and Andrew Huberman, the gym became a form of therapy, especially for young men. Social media has fueled an explosion of trends in exercise culture: 6 a.m. lifting sessions, push-pull-legs routines, bulking and cutting cycles, and tracking macros to the gram. Layered onto these regimens is a growing obsession with optimization that promotes taking pre-workout and creatine, and herbal supplements like ashwagandha and tongkat ali, which claim to boost testosterone, energy, and recovery. On the surface, these are fitness trends, but increasingly they function as a framework for mental health and self-regulation. 

For some men, these routines bring genuine physical and mental relief, providing a sense of control and structure. However, for others, even the most disciplined habits at the gym may not provide the comfort or healing they hoped for. The societal pressure to look a certain way, fuelled by social media and fitness culture, risks turning exercise and health into unhealthy obsession.

The effects of exercise on mental health have been a topic of research interest for decades. A 2024 study found that exercise, particularly walking, jogging, yoga, and strength training, significantly reduces depressive symptoms.¹ Another study directly compared the effect of exercise to antidepressants and found comparable efficacy.² Evidence from a group of randomized trials in Sports Medicine found that resistance training significantly improves anxiety symptoms in both healthy adults and those with mental illness.³ Exercise triggers the release of brain chemicals that support the formation of new neural connections, improve sleep, sharpen focus, and help the body mitigate stress.⁴ It also builds self-efficacy and interrupts rumination, which is why the American College of Sports Medicine ranked “Exercise for Mental Health” sixth on its 2026 global fitness trends list.⁴

There is no doubt that exercise benefits both mental and physical health. For many, the gym is one of the few places that offers a sense of control and agency. The problem is not the gym, or exercise itself, but the fixation that can grow around it. Research on the risks of today’s exercise trends is growing. One risk that has emerged is a condition called muscle dysmorphia, a subtype of body dysmorphic disorder, characterized by a preoccupation with insufficient muscularity. The condition disproportionately affects boys and young men.⁵ The clinical features of muscle dysmorphia are very similar to what fitness culture rewards: strict training schedules, detailed diet tracking, body checking, and prioritizing the gym over relationships, school, and work. It is increasingly difficult to distinguish between healthy discipline and harmful obsession.

Muscle dysmorphia prevalence is rising. The Canadian Study of Adolescent Health Behaviours suggests that 25.7 percent of men in their national sample were at clinical risk for muscle dysmorphia.⁶ In Canadian youth, muscle dysmorphia symptomatology has been prospectively linked to suicidal ideation and non-suicidal self-injury. Another study from the same group, published in 2025, found that viewing muscularity-oriented content on social media—muscular bodies, supplement marketing, and content featuring muscle-building drugs—was independently associated with muscle dysmorphia in boys and men.⁷ These numbers show that for a growing number of Canadian men, the pursuit of an ideal body through exercise has become a mental health crisis.

Another increasingly common problem is exercise addiction, which affects an estimated 8.1% of general exercisers.⁸ The condition shares many clinical characteristics with muscle dysmorphia. Diagnostic features include using exercise as the primary tool to regulate emotions, a growing need for more exercise to feel the same psychological effect, and feeling distress when unable to train. These are not quirks of a dedicated gym-goer, rather, they are the criteria for addiction itself. A 2025 meta-analysis found that exercise addiction was significantly associated with eating disorders, obsessive-compulsive symptoms, depression, anxiety, body image disturbance, and emotional dysregulation.⁸ Exercise addiction is often overlooked due to society’s positive associations with exercise and health, but excessive exercise can have significant physical and psychological consequences.

The pharmacological industry has taken advantage of this new, potentially unhealthy obsession with self-optimization. Testosterone Replacement Therapy (TRT) is a treatment originally indicated for men with clinically low testosterone, but its use has expanded well beyond this indication. Testosterone plays a critical role in building muscle mass, strength, and energy, which makes it an appealing target for men chasing the same physique and performance ideals that fitness culture rewards.⁹ Online platforms now promote it as a solution for fatigue, low mood, and physical performance, often implying that bigger, leaner, and more energetic bodies are just a prescription away. TRT use among men under 25 rose by 120% and among men aged 25-34 by 86% between 2018 and 2022.¹⁰ A study in European Urology Focus found that 80 to 85% of men discontinue testosterone therapy within one year because it was prescribed without necessity and failed to produce the expected benefits.¹¹

These behavioural and pharmacological patterns are closely connected. Body dissatisfaction, compulsive routines, and turning to medication or supplements often present in young men who are exposed to fitness-focused social media feeds, predatory marketing from pharmacological companies, and the pressure to buy solutions to “fix” their appearance. 

Exercise is undoubtedly beneficial for mental health, but the “gym-as-therapy” framing treats it as a complete solution. Exercise is medicine, but like any medicine, it needs the right dose, the right context, and support systems. The rise in muscle dysmorphia, exercise addiction, and off-label testosterone use is what happens when we expect exercise alone to be responsible for mental well-being. Missing a workout feels like failure, and tiredness becomes a problem that must be fixed by TRT. These trends suggest that the relationship between exercise, appearance, and men’s mental health is more complex than the classic “look good, feel good” narrative. Exercise is an effective tool, but its benefits are not guaranteed when it is entangled with a culture that equates physical optimization and psychological well-being.

References

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2. Recchia F, Leung CK, Chin EC, Fong DY, Montero D, Cheng CP, et al. Comparative effectiveness of exercise, antidepressants and their combination in treating non-severe depression: a systematic review and network meta-analysis of randomised controlled trials. Br J Sports Med. 2022;56(23):1375–80.
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